Sclerotherapy for Varicose Veins
Sclerotherapy uses an injection of a special chemical (sclerosant) into a varicose vein or spider veins. The injection damages and scars the inside lining of the vein. This causes the vein to close.
During this procedure, the affected leg is propped up to drain blood. Then the sclerosant is injected into the varicose or spider vein. This is done in a doctor's office or clinic. It takes 5 to 30 minutes. How long it takes depends on how many veins are treated and how big they are.
After the injection is given, pressure is applied over the veins. This is to prevent blood returning to the veins when you stand up. You may need to wear compression stockings for several days or weeks to maintain the pressure.
Sclerotherapy may be painful. The shot of sclerosant can cause a feeling of burning or cramping for a few minutes in the area where the shot was given. You may need repeated sessions and many injections each session. It depends on how bad the varicose and spider veins are and what type of sclerosant is used.
A newer, less invasive technique allows your doctor to inject sclerosant with a catheter. The catheter and sclerosant are guided to the affected vein with the help of duplex ultrasound. This process allows sclerotherapy treatment to be used on larger varicose veins. Previously, these large veins could only be treated surgically with ligation and stripping, in which larger varicose veins are tied off and removed.
What To Expect
For most people, sclerotherapy doesn't require any recovery period. After the treatment, you will likely be able to walk right away. Avoid strenuous exercise for 1 week after the procedure. Walk every day for at least 10 minutes. Try not to sit or lie down for long periods of time.
For the first 2 weeks after the procedure, avoid exposing your legs to the sun.
You'll probably have to wear compression stockings for a short time after having sclerotherapy.
Why It Is Done
Sclerotherapy is used to treat:
- Spider veins and small veins that aren't causing more serious problems.
- Smaller varicose veins that come back after vein-stripping surgery.
- Larger varicose veins, when less invasive techniques are used.
It may be done on its own or as a follow-up to surgery.
Sclerotherapy should not be done if you:
- Are pregnant or nursing. Experts don't know if the chemical (sclerosant) causes birth defects or gets into breast milk.
- Have a history of allergy to sclerosant or similar substances.
- Have blood clots or inflammation in the deep leg veins (deep vein thrombosis).
How Well It Works
Sclerotherapy costs less than surgery, requires no hospital stay, and allows a quicker return to work and normal activities.
Sclerotherapy can reduce symptoms and improve the look of the skin. It works in about 80 out of 100 people. It doesn't work for about 20 out of 100 people who have the procedure.footnote 1
The risks of sclerotherapy include:
- Skin colour changes along the treated vein. This is the most common side effect of sclerotherapy. The discoloration may take 6 to 12 months to go away. In some people, it may be permanent.
- Failure of treatment to prevent varicose veins from returning.
- Itching, bruising, pain, and blistering where the veins were treated.
- Scarring from ulcers or death of the tissue around the treated vein (skin or fat necrosis). This can happen if sclerosant is injected outside a vein or if sclerosant escapes through the wall of a weakened vein.
- A mild or severe (anaphylactic) reaction to the sclerosant. (Severe reaction is very rare but can be life-threatening.)
- Blood clots or damage in the deep vein system.
- Van den Bos R, et al. (2009). Endovenous therapies of lower extremity varicosities: A meta-analysis. Journal of Vascular Surgery, 49(1): 230–239.
Current as of:
July 6, 2021
Author: Healthwise Staff
E. Gregory Thompson MD - Internal Medicine
Adam Husney MD - Family Medicine
David A. Szalay MD - Vascular Surgery
Current as of: July 6, 2021
Author: Healthwise Staff
Medical Review:E. Gregory Thompson MD - Internal Medicine & Adam Husney MD - Family Medicine & David A. Szalay MD - Vascular Surgery
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